P - 79125'7 REQUEST FOR ELECTRICAL INSPECTION
1��( O�- 2 01 �4 Minnesota Board of Electricity -
1821 University Avenue Suite S-128, Saint Paul, Minnesota 55104
� (651) 642-0800 T'fY/MRS 1-800-627-3529 www.electricity.state.mn.us
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17012014
�_�� rwugnan mspecnon fteiWve07 LJ Yes
You must caU the tnspeqor when ready!
I certify Ihat I am the
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and hereby request e�.spection of the electrical worlt at: